Framing the Conversation

What should you talk about? You want to find out what people are thinking; avoid a monologue on yourself or what you what to accomplish. Ask questions. Ask if you may take notes or record the conversation. Questions sets will be different depending on the role of the person you interview. You might frame the conversation by saying "Our hospital is committed to the provision of holistic care, mind, body, and spirit. I am here today to acquire information that might improve our ability to meet the spiritual needs of physicians here. The purpose is to help me plan programs and opportunities for physicians. Your responses will be confidential, of course."

Conversations

If you work at a very large hospital,schedule interviews selectively. Generally, you want to hear from the administrative and medical staff leaders as well as physicians who are not in staff leadership roles. Sample from new physicians, mid-career and seasoned physicians. Sample from different specialties, and from high, medium, and low volume admitters. If you have a residency training program, be sure to talk to the program directors. You might interview selected nurses and other staff. After you have interviewed 8 – 10 people, you could plan your first programs, but continue taking vital signs until you have worked through your interview list. Non-physicians can help with this project if a large number of physicians will be interviewed.

Spirituality Map

Think about the idea of a spirituality map, try to determine what each of the interviewees represents. There are detectors, connectors, deflectors, inspectors and teachers. The inspectors are just sniffing around to see what is going on. They are not necessarily committed to cultural change. The detectors have detected or discovered life balance and practice as though they were in the culture of caring. The connectors have a wide network of social and professional contacts. They are the people who can influence many others on the staff. The teachers change the way others think. The deflectors are the resistant, slow adopters. With this in mind the spirituality map becomes a strategy map for cultural change.

Diagnostic Conversation

Plan to have many conversations. You might think that a series of one-on-one conversations is time consuming and that it diverts you from your primary goal of changing your medical staff to a culture of mutual care and mission alignment. On the contrary as you take the spiritual vital signs, the conversations will themselves express your care, model mutual care, and provide you with a map of spirituality in your hospital. I concede that this will be time consuming but assert that it will be enjoyable time, well spent. Interview the staff members in a relatively private place, like an office. People will be more comfortable and more easily available if you meet in their office.

Next Step

When The Eleven Questions screen shows a problem, you begin to ask questions. There are many questions to ask but the best place to start is with a simple question: "Where is the pain?"

What does the Assessment Tool tell us?

The Eleven Questions© are like a stool Hematest, though not so uncomfortable in the acquisition, nor so messy in the analysis. They don’t tell you what is wrong. They only tell you that something is wrong. If any question scores at 3 or less, it’s time to intervene. The kind of intervention will be determined by a deeper analysis. OK, so the analysis can be a little messy, and a consultant may help clarify the right steps to take.

Be a Follower

I promised to provide a guide to the results of the survey from my last post. Next time I will. Meanwhile, some of you readers might want to be a "Follower" of this blog. You can do that easily by clicking the link in the right sidebar, way down below the list of reading references. If you have a Google account (cost free), you can also opt to receive an e-mail whenever someone posts. You can always add your comments to any posting. I always appreciate feedback.

Thanks,
Malcolm

Medical Staff Culture Assessment Tool - The Eleven Questions©

Try this assessment. Ask simply whether the following behaviors in your medical staff are:

5 – Usually true 4- Often true 3-Sometimes true 2-Often false 1-Usually false

1.Physicians are deeply committed to the hospital mission.
2.Physicians do not experience malpractice suits here.
3.Patients receive high quality care.
4.Physicians cooperate with the hospital’s safety and quality initiatives.
5.Nurses and staff enjoy excellent relationships with the physicians.
6.Physicians honor and support their medical staff officers.
7.Hospital administrators enjoy good relationships with the physicians.
8.Physicians practice good ethics.
9.Patients are very satisfied with services they receive at the hospital.
10.Physicians enjoy good life balance with stable relationships at home.
11.Physicians support the hospital foundation financially.

Next time we will look at how to understand the results.

Medical Staff Culture Check

Each person within a culture has a unique perspective. Does your medical staff culture need some tuning? If one person thinks “yes” and another “no”, how can you decide? People make observations all of the time and ultimately develop a perception of the frequency of behaviors. Some will make accurate observations and others will have a “feel” for how often a behavior plays out. There will be pockets of subculture, too. In a large organization, culture may prove difficult to define. Next time I will give you eleven simple questions to ask members of your organization. The answers will pinpoint trouble spots in your medical staff.